What is Ovarian Reserve and How is it Measured?

If you're beginning your fertility journey, understanding your ovarian reserve is a critical first step in determining the right path forward. Ovarian reserve testing helps fertility specialists evaluate how many eggs you have left and, in turn, develop a personalized treatment plan tailored to your family-building goals. Dr. Ann Korkidakis, a reproductive endocrinologist at Boston IVF, explains the significance of ovarian reserve testing and how it plays a key role in assessing fertility.

What is Ovarian Reserve?
Ovarian reserve refers to the number of eggs a person has remaining in their ovaries. Unlike egg quality, which is linked to reproductive age and cannot be measured by a specific test, ovarian reserve focuses on the quantity of eggs still available. As individuals age, their ovarian reserve naturally decreases until they reach menopause, around the average age of 51. Ovarian reserve testing offers insight into this quantity and helps guide fertility treatment planning.

Why is Ovarian Reserve Important?
Every month, a group of eggs (called a cohort) is recruited from the ovaries. Of this group, typically only one egg is ovulated, while the rest of the eggs naturally die off. Over time, this monthly cycle reduces the total number of eggs remaining, which directly impacts fertility. Understanding how many eggs are available can help you and your doctor make informed decisions about your treatment options.

How is Ovarian Reserve Tested?
At Boston IVF, ovarian reserve testing involves both blood work and an ultrasound to provide a complete picture of your reproductive health. Dr. Korkidakis explains the key components of ovarian reserve testing:

1. Blood Tests (Serologic Testing): Blood tests are typically done on cycle day 2, 3, or 4 for individuals with regular menstrual cycles (cycle day 1 being the first day of full menstrual flow). If your cycles are irregular, these tests can be performed at any time of the month. Two key hormones are measured:
   • Follicle Stimulating Hormone (FSH): FSH plays a crucial role in the recruitment, development, and maturation of eggs. A higher FSH level (above 10-12) can indicate a lower ovarian reserve, as the body needs to send a stronger signal to recruit eggs when fewer are available.
   • Anti-Müllerian Hormone (AMH): AMH is produced by small follicles in the ovaries and is a reliable indicator of ovarian reserve. Higher levels of AMH suggest a healthier ovarian reserve, while values below 1 are suggestive of diminished ovarian reserve.
2. Ultrasound: An ultrasound is performed to measure the number of follicles (small fluid-filled sacs that contain immature eggs) visible in the ovaries during a given menstrual cycle. This count is known as the antral follicle count (AFC) and is used alongside blood test results to provide a fuller picture of ovarian reserve.

What Do the Results Mean?
Ovarian reserve testing results are highly individualized, and meeting with your doctor to interpret these values is essential. A low ovarian reserve does not necessarily mean that pregnancy is impossible. As Dr. Korkidakis points out, even individuals with low ovarian reserves can have successful IVF cycles. However, a diminished ovarian reserve may suggest that more than one IVF cycle could be necessary to reach your family-building goals.

The results from these tests are just one piece of the puzzle. Combined with other fertility evaluations, your Boston IVF specialist will work with you to develop a personalized treatment plan tailored to your reproductive health and goals.

Moving Forward: Your Personalized Plan
Once your ovarian reserve testing is complete, your next step is to meet with your fertility specialist to discuss the results in detail. At this follow-up appointment, your doctor will explain what the numbers mean for you specifically and what treatment options are most suitable for your journey.

Whether you’re exploring IVF, IUI, or other fertility treatments, understanding your ovarian reserve gives you the knowledge you need to make informed decisions about your next steps. Boston IVF’s team of specialists will be with you every step of the way, offering support, expertise, and a clear plan for achieving your family-building dreams.

Schedule Your Ovarian Reserve Test Today
Ovarian reserve testing is a crucial part of fertility care, providing valuable insights that help guide your treatment. At Boston IVF, we’re here to help you navigate every phase of your journey with personalized care and expertise.